Differences Over Dengue in India

This year’s protracted monsoon has also extended the dengue fever season in India, providing disease-carrying mosquitos with more breeding grounds and putting hospitals and clinics under even greater pressure than usual for this time of year.

Statistics on dengue fever cases and deaths from the virus, also known as “breakbone disease,” are patchy and often regarded by clinicians as underplayed.

Up to Sept. 30, the Ministry of Health has recorded more than 38,000 cases of dengue across India , compared to over 50,000 in the whole of 2012, which itself saw a significant uptick from the previous year.

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Dengue fever is a mosquito-borne disease characterized by high temperature and flu-like symptoms, severe muscle and bone aches and intense headaches. There is no vaccination and treatment is given only to relieve the symptoms. A patient’s platelet levels drop significantly during the infection, which in the most extreme cases can cause death from serious internal bleeding.

In India, the dengue season coincides with the monsoon rains, which usually span mid-June to mid-September but this year have extended into October in some parts.

The high rainfall provides areas for the insect vectors to breed, especially in roof-top water tanks, flower vases or in rainwater pooled on the street.

“The spread of dengue virus is heightened by long spell of monsoon rains,” A. C. Dhariwal, director of the National Vector Borne Disease Control Program told India Real Time Friday.

The local media has made much of the number of cases in the national capital, New Delhi, where 2,557 dengue cases and three deaths have been recorded so far this year.

European Pressphoto Agency

People walked through a fumigated street in New Delhi, Sep. 27.

But the areas worst hit this year are in the southern states, according to the Health Ministry, with Kerala registering 7,000 cases and 23 deaths. In Andhra Pradesh over 5,680 were infected, 12 of them died, Orissa had 5,012 cases and five deaths and in Tamil Nadu doctors treated 4,294 dengue patients, but there were no deaths in that state.

Elsewhere, the western states of Gujarat and Maharashtra also recorded over 2,600 cases each and a handful of fatalities.

“The health department is underplaying the number of dengue patients. The actual number is likely to be at least four times higher,” said S.P. Byotra, who heads the department of medicine at Sir Ganga Ram hospital based in New Delhi. The private hospital has recorded 257 cases of dengue so far this year.

He added that the official system of recording is based on disclosure from local hospitals, some of which do not send reports.

“We face the same situation year after year. The civic bodies tell us they are working to control spread of the disease. Why don’t they take better preventive steps?” Mr. Byotra said.

According to Mr. Dhariwal of the disease control program, teams of health workers have fanned out across affected states to spray pesticides as part of a door-to-door campaign and carry out regular checks. “Medical guidelines to fight the disease are available,” he added.

N.K. Yadav, a municipal health officer in Delhi said diseases such as dengue and malaria spread when “people don’t clean the water storage areas” in their houses.

He emphasized the importance of the participation of the public in controlling the disease by restricting areas where dengue mosquitos could lurk in and around houses and residential colonies.

K.T. Bhowmik, additional medical superintendent at Delhi’s Safdarjung hospital, said the seasonal drop in temperature would help contain mosquito breeding, thereby stopping the spread of the virus.

Patients with dengue-like symptoms should get tested to see if they have the disease so that their platelet level can be monitored. But “every case in which blood platelet count drops is not dengue,” Mr. Bhowmik explained.

He said the load on hospitals, flooded with dengue patients, was likely to come down with falling temperatures.

“An early winter will be good for dengue control,” the doctor added.

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